Article type
Abstract
"Background: The formulation of the questions that the guideline needs to address strongly
influences the final recommendations, so getting this right is crucial.
Objectives: To compare three approaches for selecting questions during the development of Clinical Practice Guidelines for Pediatric Intra-hospital Transfer (PIHT).
Methods: Three inquiry questionnaires with different rating questions were designed, using Delphi method for conducting the survey. The identical panel of experts was invited to participate in three rounds of inquiries, each dedicated to selecting guideline questions using a distinct type of questionnaire. In Round 1, experts were instructed to rate the importance of each candidate question, focusing on addressing the areas of greatest controversy and uncertainty. In Round 2, experts were directed to rate each question following three categories, encompassing importance and prospects for change considering the reduction of the illness burden, cost, or practice variability, along with the availability of scientific evidence. In Round 3, experts responded to each question across six categories considering different contexts of clinical practice, new evidence, significant consequences for resources or resource use or cost, and other relevant criteria. Experts completed three rounds of inquiries with a 2-week interval between each round. The total score for each question in each round, normalized to a scale of 5, along with the corresponding mean score and coefficient of variation (CV), were calculated. Candidate questions with a mean score ≥4 and those with a mean score ≥4 and CV ≤25% were analyzed separately to determine setting priorities for the guideline.
Results: A total of 49 PIHT questions were listed. 54(84.1%) experts fully participated in all three rounds. 2 questions were selected in Round 1, 12 in Round 2, and 12 in Round 3. 2 questions were across in all three rounds, while 8 were in Rounds 2 and 3. The questions selected in Rounds 1 and 2 met both criteria. However, the questions selected in Round 3 only met the criteria of a mean score ≥4.
Conclusions: Guiding experts to consider the importance of questions using three categories in Round 2 makes it easier to achieve consensus on the prioritization of guideline questions.
"
influences the final recommendations, so getting this right is crucial.
Objectives: To compare three approaches for selecting questions during the development of Clinical Practice Guidelines for Pediatric Intra-hospital Transfer (PIHT).
Methods: Three inquiry questionnaires with different rating questions were designed, using Delphi method for conducting the survey. The identical panel of experts was invited to participate in three rounds of inquiries, each dedicated to selecting guideline questions using a distinct type of questionnaire. In Round 1, experts were instructed to rate the importance of each candidate question, focusing on addressing the areas of greatest controversy and uncertainty. In Round 2, experts were directed to rate each question following three categories, encompassing importance and prospects for change considering the reduction of the illness burden, cost, or practice variability, along with the availability of scientific evidence. In Round 3, experts responded to each question across six categories considering different contexts of clinical practice, new evidence, significant consequences for resources or resource use or cost, and other relevant criteria. Experts completed three rounds of inquiries with a 2-week interval between each round. The total score for each question in each round, normalized to a scale of 5, along with the corresponding mean score and coefficient of variation (CV), were calculated. Candidate questions with a mean score ≥4 and those with a mean score ≥4 and CV ≤25% were analyzed separately to determine setting priorities for the guideline.
Results: A total of 49 PIHT questions were listed. 54(84.1%) experts fully participated in all three rounds. 2 questions were selected in Round 1, 12 in Round 2, and 12 in Round 3. 2 questions were across in all three rounds, while 8 were in Rounds 2 and 3. The questions selected in Rounds 1 and 2 met both criteria. However, the questions selected in Round 3 only met the criteria of a mean score ≥4.
Conclusions: Guiding experts to consider the importance of questions using three categories in Round 2 makes it easier to achieve consensus on the prioritization of guideline questions.
"